‘Get the patient home’

With different types of rehabilitation facilities opening up all of the time in recent years, it’s worth knowing they really aren’t all the same.

“I think the biggest misconception out there about rehabilitation facilities is people think that a rehabilitation hospital is not an actual hospital but a skilled nursing facility,” said Dr. James “Jimmy” McLean, medical director for the new Novant Health Rehabilitation Hospital in Winston-Salem, North Carolina. The facility is located at 2475 Hillcrest Center Circle off Stratford Road.

McLean said. “We’re a licensed hospital, so we can provide lab work and X-rays. As part of our license, we’re required to have a patient seen by a physician at least three days a week, but more typically we see them five or seven days a week.”

At skilled nursing facilities, which can still serve an important role in care for some patients, contact with physicians and registered nurses tends to be much less, said McLean, a physiatrist (a medical doctor specializing in rehabilitation) who in the past has seen patients in skilled nursing facilities, as well.

To clarify another misconception: Rehabilitation hospitals are not nursing homes.

“Inpatient rehab is a fairly high-energy place,” McLean said. “I visited my granny in a nursing home growing up, and you don’t get that feel. Inpatient rehab is about a team of specialists working together with patients and people getting up and out into the gym and working toward a goal, which is to get the patient home.”

Just one focus

While many rehabilitation hospital patients are often in their 70s, McLean said it’s not uncommon to see patients in their 20s recovering from trauma, brain and orthopedic injuries, or stroke. A typical patient stay is about two weeks, he said.

The new 68-bed facility that’s licensed as a stand-alone hospital will be just a few miles down the road from Novant Health Forsyth Medical Center and includes a large physical therapy gym.

McLean has led inpatient rehabilitation at Forsyth Medical Center for years. But he said Novant Health’s decision to build a new freestanding rehab hospital is part of a national trend that leads to better care for patients.

“The cool thing is the new hospital is rehab only,” McLean said. “Everyone who works there is going to be all about inpatient rehab as opposed to being part of a large medical center.”

Finding the right fit

Not everyone is the right candidate for a rehabilitation hospital – nurse evaluators help decide who’s admitted, McLean said.

“Sometimes there is a potential patient who needs rehab but does not appear to be able to tolerate the intensity of a three-hour-a-day, five-day-a-week program,” he said. “That’s where we’ll say maybe skilled care for lower-intensity therapy is best and then we’ll re-evaluate later.”

“The flipside of that is, if patients come in and they only need one discipline of therapy, like physical therapy but they don’t need speech therapy, then those folks might be better served in skilled care for a short stay and then going straight home.”

The goal is finding the best type of facility for each patient.

“We want to get people back into their home and in a safe situation,” McLean said. “From day one we’re asking, ‘What are your barriers keeping you here?’ because we know you’d rather be at the house. We make sure you’re ready to deal with stairs if you’ve got stairs at home and can get around the kitchen and bathroom.”

Growing in North Carolina

When McLean started with Novant Health in Winston-Salem in the early 90s, he was the only physiatrist in Forsyth County. But the field has slowly grown nationally since first taking off after World War II with President Franklin Roosevelt’s rehabilitation in Warm Springs, Georgia. Today, more than 8,000 such facilities can be found across the U.S.

“There’s been a real need for more inpatient rehab hospitals in North Carolina,” McLean said. “I was born and raised here, but North Carolina has become a popular place to retire, and there are a lot of new Tar Heels.”

Novant Health Rehabilitation Hospital is a joint venture with Encompass Health, a national organization specializing in rehabilitation hospitals. McLean and his provider staff at the new facility remain employees of Novant Health.